Health Underwriting Director jobs in Pierre, SD

Position Summary:

The Director of Home Health and Community Health is accountable for adhering to established policies, procedures, and eligibility requirements, admission policies, recertification procedures, Medicare guidelines, financial & budgetary constraints, management of staff, and orientation/performance evaluations of Winner Regional Health Home and Community Health staff. The Director of Home Health and Community Health has knowledge of and utilizes appropriate age-related patient care protocols relating to the physical and psychological needs of neonatal, pediatric, adolescent, adult and geriatric patients.

When students are providing patient care, treatment, and/or services as a part of their training, any/all employees may be asked to supervise the students.

Education/Experience:

Must be a graduate of a state board approved school of nursing with baccalaureate or equivalent.

Required Credentials (Licensure, Certification, or Registration):

Current South Dakota Board of Nursing license

Employment Variables:

Work hours are Monday through Friday, 8am to 5pm. May be exposed to communicable or infectious disease, hazardous materials, and injury from performance of assigned duties. Is subject to multiple sensory environmental stressors. Initial Tuberculosis (TB) test and drug screening is required by Winner Regional Health. Rubella titer will also be drawn upon hire and immunization is required if no past exposure or indication of immunization.

Required to wear name tag provided by WRH and to follow the dress code of WRH.

Job Knowledge and Skills:

Ability to read, write, speak and understand the English language. Excellent oral and written communication skills. Ability to deal with people in a professional manner. Knowledge of nursing and medical practices, procedures, laws, regulations and guidelines that pertain to home health care.

Direct Supervisor:

Chief Nursing Officer

PART II: CODE OF CONDUCT

Honesty We will do the right thing at all times, even if it is difficult, maintaining strong, ethical practices. We protect the confidentiality of others, including patients, staff and the facility as a whole. We will take responsibility for our actions.

Expertise We will demonstrate superior judgment, training and skill, at all times, demonstrating professionalism while doing so. We will perform all aspects of our job to the best of our ability, utilizing all resources and tools available.

Approachability We will be non-judgmental, friendly, and open and willing to listen to everyone we come into contact with while performing our duties. We are humble and learn from others.

Respect We will be understanding and sensitive to others’ feelings; caring and responding in a manner that sets them at ease, keeping the situation in perspective without minimizing others’ feelings or reactions. We will listen to others with full attention in a sincere, civil fashion, being careful not to be judgmental of the speaker. We maintain composure when facing conflict and avoid jumping to conclusions and defaming another’s name.

Teamwork We willingly work together with a common approach, trusting and supporting members of our organization, using our skills and resources, sharing information to achieve a common aim.

PART III: STANDARDS OF CONDUCT FOR LEADERS

Accountability

• Build meaningful teams and promote staff involvement.
• Respond to employee and/or customer concerns in a timely manner.
• Leaders will be available during business hours Monday-Friday.
• Develop and manage department budget including revenue, expense and staffing.
• Attend and participate in continuing education, meetings and seminars.

Communication

• Develop and maintain effective communication.
• Communication at all levels. Notify your department, directors, and CEO of scheduled absences.

Integrity

• Make an effort to know the directors and facility employees.
• Abide by and support employees in Winner Regional Health Standards of Conduct for Employees.
• Treat all employees with respect and fairness.

Mentor-Empower

• Motivate and develop employees.
• Reward and recognize employees with good judgment.
• Create an environment where all employees are valued and empowered to participate in solutions.
• Visibility of leadership during all shifts.

Organizational Understanding/Integration

• Link and coordinate with other departments/entities, works across boundaries, and builds mutually beneficial partnerships and networks.
• Seek information, knowledge and understanding of organizational functions, structure and overall strategic imperatives.
• Promote organizational goals by overcoming departmental or functional biases to achieve objectives.
• Promotes goals of initiative by identifying and working effectively with key stakeholders on complex cross-functional or cross-discipline teams.

PART IV: ESSENTIAL FUNCTIONS

Essential functions are critical or fundamental to the performance of the job. They are the major functions for which the person in the job is held accountable. Following are the essential functions of the job, along with the corresponding performance standards.

Function

Assumes Responsibility for Clinical Activity

• Assess and allocate personnel to maintain standard of care.
• Delegate tasks based on legal scope of practice, competency and department needs.
• Assume leadership role in high risk situations.
• Serve as a mentor to staff. Makes staff assignments based on patient need.
• Make staff assignment based on patient need.
• Demonstrate interdepartmental/interagency collaboration to meet patients’ needs.
• Participate in on-call schedule as appropriate.
• Provide data for recording statistics, billing and budgetary guidelines as directed by respective departments.
• Ensure the overall maintenance of the Home and Community Health program, providing comprehensive, cost effective quality care.
• Collaborate with the appropriate supervisor in identifying the need for planning new patient services, policies and procedures.
• Implement change to assure compliance with Medicare, Medicaid and other regulatory agencies.
• Prepare capital budget annually.

Effective Communication and Negotiation

• Facilitate conflict resolution.
• Provide clear and concise direction, feedback, and support of administrative and unit decisions to members of the health care team.
• Effectively communicate to the staff as well as educates clients and community regarding Home and Community Health.

Supervision/Functions of Home and Community Health Facility

• Supervise productivity of staff related to assessment and prioritization of the delivery of direct care using time and attendance information.
• Approve the vacation requests maintaining appropriate staffing.
• Maintain appropriate staffing ratios based upon productivity standards.
• Oversee staff and provide orientation, annual and on-going evaluation of staff.
• Delegate or refer aspects of care to health care team member consistent with their role and responsibilities and document actions.
• Assume responsibility and accountability for direct care for clients, as appropriate for licensure.
• Demonstrate clinical competence to do client set-ups, education, and troubleshooting for services as appropriate to practice privileges.

Strategic Focus

• Must work closely within the department and facility to accomplish WRH strategic priorities.
• Must be active in strategic planning within the department and facility to stay current with changes in healthcare.
• Demonstrate vision and creativity when participating in strategic and long range planning of WRH.

Workforce Focus

• Ensure task assignments are understood and appropriate.
• Adapt leadership style to situations and people.
• Provide feedback effectively.
• Provide opportunities for career development.
• Manage work force diversity by being sensitive to differences.
• Promote good employee relations and well-being.
• Follow prescribed process for assessing/validating and documenting staff competency.
• Follow prescribed process for completion of employee orientation.
• Apply effective practices in performance appraisal.
• Complete performance appraisals in the required time frame.
• Completes follow-up on action plans as necessary.
• Conduct annual educational needs assessment of staff.
• Apply effective practices in corrective/disciplinary action.
• Deal with behavior/performance requiring corrective/disciplinary action.
• Demonstrate ability to foster cooperation and communication among groups.

PART V: COMPLIANCE

Compliance

• Must comply with the Corporate Compliance Policy and all laws, rules, regulations and standards of conduct relating to the position.
• The employee has a duty to report any suspected violations of the law or the standards of conduct to the Compliance Officer or the Chief Executive Officer.

PART VI: PHYSICAL AND MENTAL REQUIREMENTS

General Activity

In a regular workday, employee may:

• Sit 1-2 Hours at a time; up to 3-4 Hours during the day
• Stand 1-2 Hours at a time; up to 3-4 Hours during the day
• Walk 1 Hours at a time; up to 3-4 Hours during the day

Motion

• Employee is required: (In terms of a regular workday, "Occasionally" equals 1% to 33%, "Frequently" 34% to 66%, "Continuously", greater than 67%.)
• Bend/Stoop Frequently Kneel, Duration 30 sec Frequently
• Squat Occasionally Balance Frequently
• Crawl, Distance Not at all Twist Frequently
• Climb, Height Frequently Keyboarding/Mousing Frequently
• Reach above shoulder level Frequently

Physical Demand

Employee’s job requires he/she carry and lift loads from the floor, from 12 inches from the floor, to shoulder height and overhead. Employee’s job requires a pushing/pulling force to move a load (not the weight of the load).

Physical Demand Classification: Carrying/lifting weight and pushing/pulling force:

• Heavy Occasionally 100 lbs.
• Frequently 50 lbs.
• Constantly 20 lbs.

Sensory Requirements:

Yes/No Explanation (if Yes)

• Speech Expressing or exchanging ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken instructions to other workers accurately, and efficiently. Yes Need to continuously communicate with patients and co-workers.
• Vision (VDT) Are there specific vision requirements for the job? Yes Work with multiple tubes, drains, monitoring equipment, etc. Must be able to visually assess patients, work with small dials, computer screens.
• Hearing Ability to receive detailed information through oral communications. Yes Need to continuously hear instructions from co-workers, requests from patients. Need to hear BP readings, assess by auscultation.

Environmental Factors

Yes/No Explanation (if Yes)

• Working on unprotected heights No
• Being around moving machinery No
• Exposure to marked changes in temperature and humidity Yes In homes without air conditioning
• Driving automotive equipment Yes To client’s home
• Wearing personal protective equipment Yes Patient care
• Exposure to atmospheric conditions (i.e. fumes, dust, odors, mists, gases, or poor ventilation) Yes Cigarette smoke / exhaust
• Exposure to extreme noise or vibration No
• Exposure to blood, body fluids and waste Yes Patient care
• Exposure to radiation Yes Dependent on patient diagnosis
• Exposure to other hazards (i.e. mechanical, electrical, burns, or explosives) Yes Pets, security, cleaning chemicals

Emotional/Psychological Factors

Yes/No Explanation (if Yes)

• Stress: Exposed to stressful situations Yes Dealing with patients, families, and others who may be very stressed. Working with a variety of co-workers at one time. Has high accountability for tasks performed.
• Concentration: Must be able to concentrate on work tasks amidst distractions. Yes Work must be done accurately. Mistakes may be harmful to patient outcome.
• Must exert self-control. Yes Due to stressful situations, must maintain composure to get work done. Will take and give direction from/to multiple sources.

PART VII: JOB RELATIONSHIPS

Supervises

0 No supervisory responsibilities

1 Supervisory responsibility

# Direct Reports: 12

# Indirect Reports:

Age of Patient Populations Served 0 Neonates: 1-30 days

0 Infant: 30 days - 1 yr

0 Children: 1- 12 yrs

0 Adolescents: 13- 18 yrs

0 Adults: 19- 70 yrs

0 Geriatrics: 70 yrs

1 All

0 Not applicable

Internal Contacts

1 Patients

1 Providers: (i.e. Physicians, Therapists, Social Workers)

1 Staff: (i.e. clinical and administrative support staff)

1 Volunteers

0 Others:

External Contacts

1 Patients

1 Families/Significant Others

1 Providers

1 Vendors

1 Community and Health Agencies

1 Regulatory agencies

1 Other: Job Applicants